Provider Demographics
NPI:1942811807
Name:DUVA, LINDSAY (PSYD)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:DUVA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 COLBORNE RD APT 19
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-4818
Mailing Address - Country:US
Mailing Address - Phone:732-995-4163
Mailing Address - Fax:
Practice Address - Street 1:1051 BEACON ST STE 204
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5622
Practice Address - Country:US
Practice Address - Phone:617-741-0680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPSY10000486103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical